WILLIAM W BACKUS HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: WILLIAM W BACKUS HOSPITAL (EIN 06-0250773)
Tax period: 2012-10-01 to 2013-09-30
Filed: 2014-08-12
IRS object ID: 201442249349301289
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule C
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-08-12T12:50:41-05:00	Timestamp
Tax Period End Date	2013-09-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	440160260	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	1201 WALNUT SUITE 1700	AddressLine1
City	KANSAS CITY	City
State	MO	State
ZIP Code	64106	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	060250773	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	THE WILLIAM W BACKUS HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	WILL	NameControl
Phone	8608898331	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	326 WASHINGTON STREET	AddressLine1
City	NORWICH	City
State	CT	State
ZIP Code	06360	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	DANIEL E LOHR	Name
Title	SENIOR VP/CFO	Title
Phone	8608898331	Phone
Date Signed	2014-08-12	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	MICHAEL J ENGLE	Name
PTIN	P00482834	PTIN
Phone	8162216300	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	DANIEL E LOHR	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	326 WASHINGTON STREET	AddressLine1
City	NORWICH	City
State	CT	State
ZIP Code	06360	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	332093794	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.BACKUSHOSPITAL.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1891	YearFormation
State Legal Domicile	CT	StateLegalDomicile
Activity Or Mission Description	BACKUS HOSPITAL DELIVERS AND COORDINATES A CONTINUUM OF HIGH-QUALITY HEALTH CARE THAT IS SENSITIVE TO THE NEEDS OF INDIVIDUALS IN EASTERN CONNECTICUT.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	15	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	2133	TotalNbrEmployees
Total Nbr Volunteers	465	TotalNbrVolunteers
Total Gross UBI	2234756	TotalGrossUBI
Net Unrelated Business Txbl Income	219181	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	1179014	ContributionsGrantsPriorYear
Contributions Grants Current Year	1225848	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	285997171	ProgramServiceRevenuePriorYear
Program Service Revenue CY	279344487	ProgramServiceRevenueCY
Investment Income Prior Year	4525194	InvestmentIncomePriorYear
Investment Income Current Year	6336590	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1628784	OtherRevenuePriorYear
Other Revenue Current Year	2501468	OtherRevenueCurrentYear
Total Revenue Prior Year	293330163	TotalRevenuePriorYear
Total Revenue Current Year	289408393	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	752684	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	130303	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	146148497	SalariesEtcPriorYear
Salaries Etc Current Year	144190562	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	437085	TotalFundrsngExpCurrentYear
Other Expense Prior Year	115188670	OtherExpensePriorYear
Other Expenses Current Year	113205414	OtherExpensesCurrentYear
Total Expenses Prior Year	262089851	TotalExpensesPriorYear
Total Expenses Current Year	257526279	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	31240312	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	31882114	RevenuesLessExpensesCY
Total Assets BOY	393284501	TotalAssetsBOY
Total Assets EOY	477063817	TotalAssetsEOY
Total Liabilities BOY	195088980	TotalLiabilitiesBOY
Total Liabilities EOY	151234531	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	198195521	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	325829286	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	THE WILLIAM W BACKUS HOSPITAL DELIVERS AND COORDINATES A CONTINUUM OF HIGH QUALITY HEALTH CARE THAT IS SENSITIVE TO THE NEEDS OF INDIVIDUALS IN EASTERN CONNECTICUT. THE HOSPITAL IS COMMITTED TO BEING RESPONSIVE AND ACCOUNTABLE TO THOSE FOR WHOSE BENEFIT IT EXISTS, AND TO IMPROVING THE HEALTH OF ITS COMMUNITIES.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	209142811	Expense
Grants	130303	Grants
Revenue	278231478	Revenue
Description	IN FISCAL YEAR 2013, BACKUS HOSPITAL HAD 10,573 ADMISSIONS, 78,884 EMERGENCY DEPARTMENT VISITS, AND 460,916 OUTPATIENT VISITS. THE HOSPITAL DELIVERED 860 BABIES AND 6,323 SAME DAY SURGICAL PROCEDURES. BACKUS PERFORMED 128,607 OUTPATIENT IMAGING EXAMS, 7,132 MRI EXAMINATIONS, 7,973 PSYCHIATRIC CLINICAL VISITS AND 7,992 PSYCHIATRIC PARTIAL HOSPITAL VISITS.	Description
Total Program Service Expense	209142811	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	1	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	204	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	2133	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	1	QuidProQuoContributions
Quid Pro Quo Disclosure	1	QuidProQuoDisclosure
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	15	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	1	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	0	WrittenPolicyOrProcedure
Other Website	X	OtherWebsite
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	DANIEL LOHR	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	8608898331	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	326 WASHINGTON STREET	AddressLine1
City	NORWICH	City
State	CT	State
ZIP Code	06360	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
DAVID WHITEHEAD
TRUSTEE/PRESIDENT/CEO	40.00	7.00	X	X	1054517	0	39768
JOHN BILDA
TRUSTEE	2.00	1.00	X		0	0	0
STEPHEN BRIGGS
TRUSTEE	2.00	1.00	X		0	0	0
ELIZABETH CONWAY
TRUSTEE/VICE CHAIRMAN	6.00	1.00	X	X	0	0	0
KARIN EDWARDS
TRUSTEE	2.00	1.00	X		0	0	0
NANCY GENTES
TRUSTEE	2.00	1.00	X		0	0	0
ANTHONY JOYCE
TRUSTEE/CHAIRMAN	6.00	1.00	X	X	0	0	0
PETER MANERI
TRUSTEE	2.00	1.00	X		0	0	0
PAUL MAXFIELD
TRUSTEE	2.00	1.00	X		0	0	0
DEBORAH MONAHAN
TRUSTEE/SECRETARY	6.00	1.00	X	X	0	0	0
LYNNE QUINTAL-HILL
TRUSTEE	2.00	1.00	X		0	0	0
ROBERT RAMSDELL
TRUSTEE/TREASURER	6.00	1.00	X	X	0	0	0
DONNA ROMITO
TRUSTEE	2.00	1.00	X		0	0	0
DENNIS SLATER
TRUSTEE	2.00	1.00	X		0	0	0
MARK TRAMONTOZZI
TRUSTEE	2.00	1.00	X		0	0	0
DANIEL LOHR
SENIOR VP/CFO	40.00	9.00		X	713794	0	39768
PETER SHEA
SENIOR VP/MEDICAL DIRECTOR	40.00				636111	0	39184	X
SERGIO CASILLAS
PHYSICIAN	40.00				495341	0	39184		X
ROBERT SIDMAN
PHYSICIAN	40.00				422418	0	39415		X
MARK TOUSIGNANT
PHYSICIAN	40.00				514535	0	39184		X
FRED FENTON
PHYSICIAN	40.00				341303	0	46915		X
RICHARD GOULDING
PHYSICIAN	40.00				358979	0	39184		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	4536998	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	322602	TotalOtherCompensation
Number Individuals GT100 K	167	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
ALLIANCE HEALTHCARE SERVICES
PO BOX 96485	CHICAGO	IL	60693	MEDICAL SERVICES	3137705
NAVIN HAFTY & ASSOC
1900 WEST PARK DRIVE STE 180	WESTBOROUGH	MA	01581	CONSULTING	2548871
YALE NEW HAVEN HOSPITAL
20 YORK STREET	NEW HAVEN	CT	06504	MEDICAL SERVICES	1945762
EXECUTIVE HEALTH RESOURCES
PO BOX 822688	PHILADELPHIA	PA	19182	CONSULTING	1106719
DAVITA INC
PO BOX 8500-1607	PHILADELPHIA	PA	19178	MEDICAL SERVICES	498533

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	36	NumberOfContractorsGT100K
Fundraising Events	101867	FundraisingEvents
Related Organizations	3500	RelatedOrganizations
Government Grants	586588	GovernmentGrants
All Other Contributions	533893	AllOtherContributions
Noncash Contributions	3894	NoncashContributions
Total Contributions	1225848	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
INPATIENT	900099	118361330	118361330
OUTPATIENT	900099	103455748	103455748
EMERGENCY DEPT	900099	52725675	52725675
EHR REVENUE	900099	2611725	2611725
LAB COURIER SERVICE	621500	2190009		2190009

Field	Value	IRS element (for citing)
Total Program Service Revenue	279344487	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	3582788	TotalRevenueColumn
Exclusion	$3,582,788	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	879099	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	1241059	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-361960	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-361960	TotalRevenueColumn
Exclusion	-$361,960	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	43451957	Securities
Other	337151	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	40559506	Securities
Other	475800	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	2892451	Securities
Other	-138649	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	2753802	TotalRevenueColumn
Exclusion	$2,753,802	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	30320	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	101867	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	43976	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	-13656	TotalRevenueColumn
Exclusion	-$13,656	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	515308	GrossSalesOfInventory
Cost Of Goods Sold	365060	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	150248	TotalRevenueColumn
Exclusion	$150,248	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA	722320	1225242	$1,225,242
CHILD CARE	624410	379847	$379,847
PURCHASE DISCOUNTS	900099	218906		218906

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	902841	TotalRevenueColumn
Related Or Exempt Function Income	858094	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	44747	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Other Revenue	2726836	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	289408393	TotalRevenueColumn
Related Or Exempt Function Income	278231478	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	2234756	UnrelatedBusinessRevenue
Exclusion	$7,716,311	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	117803	Total
Program Services	117803	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	12500	Total
Program Services	12500	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	2034773	Total
Program Services	577237	ProgramServices
Management And General	1457536	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	115218074	Total
Program Services	100571289	ProgramServices
Management And General	14537332	ManagementAndGeneral
Fundraising	109453	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	7678569	Total
Program Services	6680355	ProgramServices
Management And General	992071	ManagementAndGeneral
Fundraising	6143	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	10827673	Total
Program Services	9420076	ProgramServices
Management And General	1398935	ManagementAndGeneral
Fundraising	8662	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	8431473	Total
Program Services	7335382	ProgramServices
Management And General	1089349	ManagementAndGeneral
Fundraising	6742	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	1475968	Total
Management And General	1475968	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	346185	Total
Management And General	346185	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	51325	Total
Management And General	51325	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	109002	Total
Management And General	109002	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	16509418	Total
Program Services	13411828	ProgramServices
Management And General	3097590	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	132453	Total
Program Services	110611	ProgramServices
Fundraising	21842	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	5140225	Total
Program Services	3913243	ProgramServices
Management And General	1218057	ManagementAndGeneral
Fundraising	8925	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	3596627	Total
Program Services	492509	ProgramServices
Management And General	3104118	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	5261549	Total
Program Services	452531	ProgramServices
Management And General	4809018	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	210558	Total
Program Services	77355	ProgramServices
Management And General	133203	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	14710	Total
Program Services	2085	ProgramServices
Management And General	12625	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	3170525	Total
Management And General	3170525	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	14971813	Total
Program Services	7108267	ProgramServices
Management And General	7863546	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	5126318	Total
Program Services	4531196	ProgramServices
Management And General	595122	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL EXPENSES	34713650	34713650
BAD DEBT	8725735	8723935	1800
MAINT/SERVICE CONTRACTS	4894477	3710464	1184013
LAB EXPENSES	4113229	4113229

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	4641647	Total
Program Services	3067266	ProgramServices
Management And General	1299063	ManagementAndGeneral
Fundraising	275318	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	257526279	Total
Program Services	209142811	ProgramServices
Management And General	47946383	ManagementAndGeneral
Fundraising	437085	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	3816199	BOY
EOY	1643564	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	103907072	BOY
EOY	130996812	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	31723	BOY
EOY	29416	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	32015340	BOY
EOY	31013657	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	74517	BOY
EOY	53821	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	3602936	BOY
EOY	3778841	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	5066915	BOY
EOY	2941851	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	299682104	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	160938198	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	91354486	BOY
EOY	138743906	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	147043829	BOY
EOY	158491234	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	12632	BOY
EOY	12632	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	6358852	BOY
EOY	9358083	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	393284501	BOY
EOY	477063817	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	23583670	BOY
EOY	21300221	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	59265000	BOY
EOY	62005476	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	1126557	BOY
EOY	1527930	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	111113753	BOY
EOY	66400904	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	195088980	BOY
EOY	151234531	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	187548862	BOY
EOY	314456228	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2890743	BOY
EOY	3305592	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	7755916	BOY
EOY	8067466	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	198195521	BOY
EOY	325829286	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	393284501	BOY
EOY	477063817	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	31882114	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	5113161	ReconciliationUnrealizedInvest
Reconcilation Invest Expenses	-393191	ReconcilationInvestExpenses
Reconcilation Other Changes	91031681	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Both	X	FinancialStatementBoth

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	1	GrantsOtherOrganizations
Grants Other Organizations	$51,325	GrantsOtherOrganizationsAmount
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	51325	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	5396859	BeginningOfYearBalance
Investment Earnings Or Losses	159637	InvestmentEarningsOrLosses
Administrative Expenses	4511	AdministrativeExpenses
End Of Year Balance	5551985	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	5396859	BeginningOfYearBalance
Investment Earnings Or Losses	5226	InvestmentEarningsOrLosses
Administrative Expenses	5226	AdministrativeExpenses
End Of Year Balance	5396859	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	5320786	BeginningOfYearBalance
Contributions	5000	Contributions
Investment Earnings Or Losses	76505	InvestmentEarningsOrLosses
Administrative Expenses	5432	AdministrativeExpenses
End Of Year Balance	5396859	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4841631	BeginningOfYearBalance
Contributions	358064	Contributions
Investment Earnings Or Losses	505259	InvestmentEarningsOrLosses
Other Expenditures	378271	OtherExpenditures
Administrative Expenses	5897	AdministrativeExpenses
End Of Year Balance	5320786	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3871631	BeginningOfYearBalance
Contributions	970000	Contributions
Investment Earnings Or Losses	142089	InvestmentEarningsOrLosses
Other Expenditures	135254	OtherExpenditures
Administrative Expenses	6835	AdministrativeExpenses
End Of Year Balance	4841631	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5011878	OtherCostOrOtherBasis
Book Value	5011878	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	10381267	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	117921709	OtherCostOrOtherBasis
Depreciation	35489934	Depreciation
Book Value	92813042	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	63741714	OtherCostOrOtherBasis
Depreciation	51595691	Depreciation
Book Value	12146023	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	102548384	OtherCostOrOtherBasis
Depreciation	73852573	Depreciation
Book Value	28695811	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	77152	OtherCostOrOtherBasis
Book Value	77152	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	138743906	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescription	AmountAmount
DUE TO 3RD PARTIES	$17,467,823
EMPLOYEE RELATED OBLIGATIONS	$21,820,825
SELF-INSURED PROF LIABILITY	$14,348,700
CAPITAL LEASE OBLIGATIONS	$6,103,598
OTHER LIABILITIES	$6,659,958

Field	Value	IRS element (for citing)
Total Of Amounts	66400904	TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt	295396450	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	5113161	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	5113161	RevenueNotRptdF990
Revenue Subtotal	290283289	RevenueSubtotal
Investment Expenses Not Included	393191	InvestmentExpensesNotIncluded
Other Revenues Not Included	-1268087	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	-874896	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	289408393	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	258797835	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	1423684	OtherExpensesIncluded
Expenses Not Rptd F990	1423684	ExpensesNotRptdF990
Expenses Subtotal	257374151	ExpensesSubtotal
Other Expenses Not Included	152128	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	152128	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	257526279	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	THE PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE MEANT TO PROVIDE LONG TERM SUPPORT FOR CAPITAL AND OPERATING PROGRAMS FOR THE HOSPITAL IN ACCORDANCE WITH THE DONOR'S WISHES.
PART XI, LINE 4B - OTHER ADJUSTMENTS:		AUXILIARY INCOME-156,999 K-1 PASSTHROUGH-(1,402) LOSS ON FIXED ASSETS-(138,649) RENTAL EXPENSES-(1,241,059) GOLF TOURNAMENT EXPENSES-(43,976)
PART XII, LINE 2D - OTHER ADJUSTMENTS:		RENTAL EXPENSES-1,241,059 GOLF TOURNAMENT EXPENSES-43,976 LOSS ON FIXED ASSETS-138,649
PART XII, LINE 4B - OTHER ADJUSTMENTS:		AUXILIARY EXPENSES-152,128
		SCHEDULE D PART X LINE 2: ASC 740-10, UNCERTAIN TAX POSITIONS, PRECRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN.THIS INTERPRETATION ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, AND DISCLOSURE REQUIREMENTS FOR UNCERTAIN TAX POSITION.MANAGEMENT HAS EVALUATED THE IMPLICATIONS OF ASC 740-10 AND DETERMINED THAT ITS IMPACT ON THE FINANCIAL STATEMENTS IS NOT SIGNIFICANT.

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	GOLF TOURNAMENT	NameOfEvent1
Gross Receipts Event1	91435	GrossReceiptsEvent1
Charitable Contributions Event1	69035	CharitableContributionsEvent1
Gross Revenue Event1	22400	GrossRevenueEvent1
Non Cash Prizes Event1	12420	NonCashPrizesEvent1
Rent Facility Costs Event1	11200	RentFacilityCostsEvent1
Food And Beverage Event1	3082	FoodAndBeverageEvent1
Other Direct Expenses Event1	1791	OtherDirectExpensesEvent1
Name Of Event2	SEDER GOLF TOURNAMENT	NameOfEvent2
Gross Receipts Event2	40752	GrossReceiptsEvent2
Charitable Contributions Event2	32832	CharitableContributionsEvent2
Gross Revenue Event2	7920	GrossRevenueEvent2
Rent Facility Costs Event2	13254	RentFacilityCostsEvent2
Food And Beverage Event2	765	FoodAndBeverageEvent2
Entertainment Event2	750	EntertainmentEvent2
Other Direct Expenses Event2	714	OtherDirectExpensesEvent2
Gross Receipts Total	132187	GrossReceiptsTotal
Charitable Contributions Total	101867	CharitableContributionsTotal
Gross Revenue Total Events	30320	GrossRevenueTotalEvents
Non Cash Prizes Total Events	12420	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	24454	RentFacilityCostsTotalEvents
Food And Beverage Total Events	3847	FoodAndBeverageTotalEvents
Entertainment Total Events	750	EntertainmentTotalEvents
Other Direct Expenses Total Events	2505	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	43976	DirectExpenseSummaryEvents
Net Income Summary	-13656	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	250.000000000000	FreeOtherPercentage

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	0	ExpensesExceededBudget
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3145248	TotalCommunityBenefitExpense
Direct Offsetting Revenue	525427	DirectOffsettingRevenue
Net Community Benefit Expense	2619821	NetCommunityBenefitExpense
Percent Of Total Expense	0.01050	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	58661230	TotalCommunityBenefitExpense
Direct Offsetting Revenue	40262278	DirectOffsettingRevenue
Net Community Benefit Expense	18398952	NetCommunityBenefitExpense
Percent Of Total Expense	0.07400	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	61806478	TotalCommunityBenefitExpense
Direct Offsetting Revenue	40787705	DirectOffsettingRevenue
Net Community Benefit Expense	21018773	NetCommunityBenefitExpense
Percent Of Total Expense	0.08450	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	78	NumberOfActivitiesOrPrograms
Persons Served	37619	PersonsServed
Total Community Benefit Expense	850994	TotalCommunityBenefitExpense
Direct Offsetting Revenue	14110	DirectOffsettingRevenue
Net Community Benefit Expense	836884	NetCommunityBenefitExpense
Percent Of Total Expense	0.00340	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	15	NumberOfActivitiesOrPrograms
Persons Served	848	PersonsServed
Total Community Benefit Expense	174283	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5000	DirectOffsettingRevenue
Net Community Benefit Expense	169283	NetCommunityBenefitExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Persons Served	19841	PersonsServed
Total Community Benefit Expense	3935738	TotalCommunityBenefitExpense
Net Community Benefit Expense	3935738	NetCommunityBenefitExpense
Percent Of Total Expense	0.01580	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	27352	TotalCommunityBenefitExpense
Net Community Benefit Expense	27352	NetCommunityBenefitExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	15	NumberOfActivitiesOrPrograms
Persons Served	120	PersonsServed
Total Community Benefit Expense	87248	TotalCommunityBenefitExpense
Net Community Benefit Expense	87248	NetCommunityBenefitExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	108	NumberOfActivitiesOrPrograms
Persons Served	58428	PersonsServed
Total Community Benefit Expense	5075615	TotalCommunityBenefitExpense
Direct Offsetting Revenue	19110	DirectOffsettingRevenue
Net Community Benefit Expense	5056505	NetCommunityBenefitExpense
Percent Of Total Expense	0.02040	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	108	NumberOfActivitiesOrPrograms
Persons Served	58428	PersonsServed
Total Community Benefit Expense	66882093	TotalCommunityBenefitExpense
Direct Offsetting Revenue	40806815	DirectOffsettingRevenue
Net Community Benefit Expense	26075278	NetCommunityBenefitExpense
Percent Of Total Expense	0.10490	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	7	NumberOfActivitiesOrPrograms
Total Community Building Expense	39641	TotalCommunityBuildingExpense
Net Community Building Expense	39641	NetCommunityBuildingExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Total Community Building Expense	1126	TotalCommunityBuildingExpense
Net Community Building Expense	1126	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Total Community Building Expense	1319	TotalCommunityBuildingExpense
Net Community Building Expense	1319	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Total Community Building Expense	5117	TotalCommunityBuildingExpense
Net Community Building Expense	5117	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	7	PersonsServed
Total Community Building Expense	691	TotalCommunityBuildingExpense
Net Community Building Expense	691	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	560	TotalCommunityBuildingExpense
Net Community Building Expense	560	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	16	NumberOfActivitiesOrPrograms
Persons Served	7	PersonsServed
Total Community Building Expense	48454	TotalCommunityBuildingExpense
Net Community Building Expense	48454	NetCommunityBuildingExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$3,352,286	BadDebtExpenseAmount
Amount Attributable To	2556613	AmountAttributableTo
Amount Reimbursed By Medicare	50291272	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	68283759	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-17992487	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	THE WILLIAM W BACKUS HOSPITAL	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	326 WASHINGTON STREET	AddressLine1
City	NORWICH	City
State	CT	State
ZIP Code	06360	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	THE WILLIAM W BACKUS HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Information Gaps	X	InformationGaps
Needs Assessment Conducted	12	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	0	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Other Method	X	OtherMethod
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	0	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	250.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	400.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Average Negotiated Rates	X	AverageNegotiatedRates
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	10	NumberOfOtherFacilities

Other Facilities OtherFacilities (10 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
BACKUS OUTPATIENT CARE CENTER
111 SALEM TURNPIKE	NORWICH	CT	06360	OUTPATIENT SERVICES
MEDICAL OFFICE BUILDING
330 WASHINGTON STREET	NORWICH	CT	06360	RADIATION THERAPY/LAB
COLCHESTER BACKUS HEALTH CENTER
163 BROADWAY	COLCHESTER	CT	06415	RADIOLOGY/LAB/PRIMARY CARE
MONTVILLE BACKUS HEALTH CARE
80 NORWICH/NEW LONDON TURNPIKE	UNCASVILLE	CT	06382	RADIOLOGY/LAB/PRIMARY CARE
LEDYARD BACKUS HEALTH CENTER
743 COLONEL LEDYARD HIGHWAY	LEDYARD	CT	06339	LAB/PRIMARY CARE
JEWETT CITY PATIENT SERVICE CENTER
70 MAIN STREET	JEWETT CITY	CT	06351	LAB
INFECTIOUS DISEASE CLINIC
107 LAFAYETTE STREET	NORWICH	CT	06360	CLINIC
NORTH STONINGTON BACKUS HEALTH CENTER
82 NORWICH-WESTERLY ROAD	NORTH STONINGTON	CT	06359	PRIMARY CARE
NORWICHTOWN BACKUS PATIENT SERVICE CTR
55 TOWN STREET	NORWICH	CT	06360	LAB
PLAINFIELD EMERGENCY CENTER
582 NORWICH ROAD	PLAINFIELD	CT	06374	LAB/RADIOLOGY/EMERGENCY SERVICES

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 8725735.
PART III, LINE 4: SEE PAGES 13&14 OF THE AUDITED FINANCIAL STATEMENTS. LINE 3-COST METHODOLOGY EQUALS RCC FROM 2013 OHCA FILING. PORTION OF BAD DEBT CONSIDERED COMMUNITY BENEFIT IS BASED ON THE COST OF THE ACCOUNTS RETURNED FROM THE COLLECTION AGENCY AS UNCOLLECTIBLE.
PART III, LINE 8: THE MEDICARE SHORTFALL WAS NOT INCLUDED IN THE COMMUNITY BENEFIT COST. THE COSTING METHODOLOGY CONSISTED OF INFORMATION FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM AS WELL AS COSTS FROM THE MEDICARE COST REPORT
PART III, LINE 9B: IN THE SELF-PAY POLICY, SECTION IIB, STATES THAT THE MEDICAL BUREAU OF ECONOMICS (MBE) RECEIVES A WEEKLY LIST OF PATIENTS WHO WERE SENT FINANCIAL ASSISTANCE APPLICATIONS FROM BACKUS STAFF. THIS INFORMATION IS FROM THE PATIENT ACCOUNTS OR FINANCIAL COUNCELING DEPARTMENTS. MBE'S COLLECTION ACTIVITY ON THESE PATIENTS IS HAULTED UNTIL IT HAS BEEN DETERMINED IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY,BY THE HOSPITAL FINANCIAL COUNCELING UNIT. COLLECTION ACTION IS ONLY RESUMED ONCE IT IS DETERMINED THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE.
PART V, SECTION B, LINE 3: IN THE MOST RECENT CHNA, WILLIAM W. BACKUS HOSPITAL CONTRACTED WITH HOLLERAN, AN INDEPENDENT RESEARCH AND CONSULTING FIRM LOCATED IN LANCASTER, PENNSYLVANIA. A SAMPLE OF 461 INDIVIDUALS WHO RESIDE WITHIN EASTERN CONNECTICUT WERE INTERVIEWED BY TELEPHONE TO ASSESS THEIR HEALTH BEHAVIORS, PREVENTATIVE PRACTICES, AND ACCESS TO HEALTH CARE. INDIVIDUALS WERE RANDOMLY SELECTED FOR PARTICIPATION BASED ON A STATISTICALLY VALID SAMPLING FRAME DEVELOPED BY HOLLERAN. THE SAMPLING FRAME REPRESENTED 24 ZIP CODES WITHIN THE HOSPITAL'S SERVICE AREA. INTERVIEWS WERE CONDUCTED BY HOLLERAN'S TELE-RESEARCH CENTER BETWEEN THE DATES OF JULY 24, 2012 AND SEPTEMBER 6, 2012. INTERVIEWERS CONTACTED RESPONDENTS VIA LAND-LINE TELEPHONE NUMBERS GENERATED FROM A RANDOM CALL LIST. EACH INTERVIEW LASTED APPROXIMATELY 12 - 15 MINUTES DEPENDING ON THE CRITERIA MET AND WAS COMPLETELY CONFIDENTIAL. ONLY RESPONDENTS WHO WERE AT LEAST 18 YEARS OF AGE AND LIVED IN A PRIVATE RESIDENCE WERE INCLUDED. THE SURVEY WAS ADAPTED FROM THE CENTER FOR DISEASE CONTROL AND PREVENTION'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS). BRFSS IS THE LARGEST TELEPHONE HEALTH SURVEY IN THE WORLD. IT IS USED NATIONALLY TO IDENTIFY NEW HEALTH PROBLEMS, MONITOR CURRENT PROBLEMS AND GOALS, AND ESTABLISH AND EVALUATE HEALTH PROGRAMS AND POLICIES. THE SURVEY TOOL CONSISTED OF APPROXIMATELY 100 FACTORS SELECTED FROM THE 2010 AND 2011 BRFSS TOOLS. THE FACTORS WERE CHOSEN BY WILLIAM W. BACKUS HOSPITAL, IN CONSULTATION WITH HOLLERAN AND ADDRESSED 27 HEALTH-RELATED TOPICS RANGING FROM GENERAL HEALTH STATUS TO CHILD HUMAN PAPILLOMA VIRUS. IN ADDITION, BRFSS RESULTS FOR CONNECTICUT AND THE UNITED STATES ARE INCLUDED WHEN AVAILABLE TO INDICATE HOW THE HEALTH STATUS OF WILLIAM W. BACKUS HOSPITALS SERVICE AREA COMPARES ON A STATE AND NATIONAL LEVEL.THE SUMMARY REPORT IS AVAILABLE AT: HTTP://BACKUSHOSPITAL.ORG/WP-CONTENT/UPLOADS/2013/05/CHNA-FINAL-REPORT.PDF	THE WILLIAM W BACKUS HOSPITAL
PART V, SECTION B, LINE 5C: THE CHNA REPORT WAS MADE WIDELY AVAILABLE TO THE PUBLIC. INFORMATION ABOUT THE CHNA AND ITS MAJOR FINDINGS AND IMPLEMENTATION STRATEGY APPEARED IN HEALTHY CONNECTIONS AND THE HOSPITELL. BACKUS HOSPITAL PUBLISHES HEALTHY CONNECTIONS EACH MONTH AS A COMMUNITY SERVICE TO THE RESIDENTS OF EASTERN CONNECTICUT. INFORMATION IN HEALTHY CONNECTIONS COMES FROM A WIDE RANGE OF MEDICAL RESOURCES. THE HOSPITELL IS A WEEKLY NEWSLETTER FOR BACKUS EMPLOYEES, VOLUNTEERS, PATIENTS, AND COMMUNITY MEMBERS. IT IS KEEPS READERS UPDATED ON HOSPITAL NEWS AND CAN BE FOUND IN PRINTED FORM IN THE HOSPITAL AND ITS OFFSITE LOCATIONS AND IT CAN ALSO BE FOUND ONLINE AT THE HOSPITAL'S WEBSITE. THE ENTIRE NEEDS ASSESSMENT IS MADE AVAILABLE TO THE PUBLIC VIA THE HOSPITALS WEBSITE AND CAN BE FOUND AT WWW.BACKUSHOSPITAL.ORG/HEALTHSURVEY.	THE WILLIAM W BACKUS HOSPITAL
PART V, SECTION B, LINE 7: BY FOCUSING EFFORTS THE CROSS-CUTTING ISSUES OF ACCESS TO CARE, PREVENTATIVE HEALTH (INCLUDING CHRONIC AND INFECTIOUS DISEASE, RESPIRATORY HEALTH, AND OBESITY), AND MENTAL HEALTH (INCLUDING SUBSTANCE ABUSE), THE BACKUS HEALTH SYSTEM WILL TAKE A COMPREHENSIVE APPROACH TO ADDRESSING EIGHT OF THE NINE MOST URGENT NEEDS IN THE COMMUNITIES IT SERVES. AS WITH ALL BACKUS HEALTH SYSTEM PROGRAMS, IT WILL CONTINUE TO MONITOR COMMUNITY NEEDS AND ADJUST PROGRAMMING AND SERVICES ACCORDINGLY.BACKUS RECOGNIZES THAT THERE ARE NUMEROUS PARTNERS IN THE COMMUNITY THAT CAN HELP TO IMPROVE THE IDENTIFIED HEALTH NEEDS. IN SOME CASES, PARTNERS ARE BETTER SUITED TO LEAD THE INITIATIVE TO IMPACT CERTAIN HEALTH NEEDS. SUCH IS THE CASE WITH THE BUILT ENVIRONMENT. BACKUS HEALTH SYSTEM WILL SUPPORT ONGOING AND NEW EFFORTS TO IMPROVE THE COMMUNITY'S PHYSICAL ENVIRONMENT AND INFRASTRUCTURE TO IMPROVE SAFETY, THE TRANSPORTATION SYSTEM, AND CREATE MORE OPPORTUNITIES FOR PHYSICAL ACTIVITY, BUT SEES ITS PRIMARY ROLE AS ALLOCATING RESOURCES TO ADDRESS DIRECT HEALTH NEEDS FOR THE COMMUNITY.	THE WILLIAM W BACKUS HOSPITAL
IN 2012, BACKUS COMMISSIONED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY HOLLERAN, A PROFESSIONAL RESEARCH FIRM. THE ASSESMENT CONSISTED OF 461 TELEPHONE INTERVIEWS WHICH WERE CONDUCTED THROUGHOUT THE HOSPITAL'S SERVICE REGION (BOTH NEW LONDON AND WINDOM COUNTIES). THE ASSESSMENT ALSO INCLUDED A DETAIED ANALYSIS OF SECONDARY DATA SOURCES, AS WELL AS KEY INFORMANT INTERVIEWS AND THREE FOCUS GROUPS. THE NEEDS ASSESSMENT WAS PRESENTED AND DISTRIBUTED, AND CAN BE ACCESSED AT WWW.BACKUSHOSPITAL.ORG/HEATLHSURVEY. THE SUMMARY REPORT IS AVAILABLE AT: HTTP://BACKUSHOSPITAL.ORG/WP-CONTENT/UPLOADS/2013/05/CHNA-FINAL-REPORT.PDF	NEEDS ASSESSMENT	PART V SECTION B
NOTIFICATION ABOUT CHARITABLE CARE AND ASSISTANCE PROGRAMS IS AVAILABLE AT ALL REGRISTRATION AREAS, ON AND OFF THE MAIN HOSPITAL CAMPUS, IN WAITING AREAS, IN THE PATIENT HANDBOOK, ON OUR WEBSITE, ON PROMINENTLY PLACED SIGNS (IN ENGLISH AND IN SPANISH). ADDITIONALLY, CARE MANAGEMENT SOCIAL WORKERS MEET WITH PARENTS, FAMILY, CLERGY, AND OTHERS AS APPROPRIATE TO DISCUSS ASSISTANCE PROGRAMS AND SERVICES THAT MAY BE AVAILABLE. IN ADDITION TO THE COMPLETE FINANCIAL ASSISTANCE POLICY AND APPLICATION FOR FINANCIAL ASSISTANCE, HERE IS THE INFORMATION INCLUDED ON THE HOSPITAL WEBSITE:FINANCIAL ASSISTANCEBACKUS HOSPITAL PROVIDES FINANCIAL ASSISTANCE PROGRAMS FOR CERTAIN QUALIFIED PATIENTS WHO ARE UNABLE TO PAY ALL OR PART OF THEIR BILL FOR INPATIENT, OUTPATIENT AND EMERGENCY SERVICES RENDERED AT THE HOSPITAL.IF YOU ARE COPING WITH A FINANCIAL HARDSHIP, AND ARE FACING DEBTS OWED TO BACKUS HOSPITAL, FINANCIAL ASSISTANCE MAY BE AVAILABLE TO YOU.INCOME VERIFICATIONBACKUS REQUESTS INCOME INFORMATION FROM THE APPLICANT. VERIFICATION OF REPORTED INCOME SHOULD BE INCLUDED WITHIN THE APPLICATION PACKAGE.APPROPRIATE VERIFICATION SOURCES INCLUDE: MOST RECENT FEDERAL TAX RETURN AND W-2 MOST RECENT 3 PAYROLL CHECKS COPIES OF UNEMPLOYMENT CHECKS COPIES OF ANY PENSION, ALIMONY, CHILD SUPPORT OR OTHER SOURCES OF INCOME COPIES OF SOCIAL SECURITY EARNINGS, IF ANY ANY OTHER PERTINENT INFORMATIONIF THE APPLICANT HAS NO INCOME A STATEMENT DETAILING THE CURRENT METHOD OF SUPPORT WILL BE ACCEPTED. PROOF OF INCOME OR EARNINGS IS REQUIRED WITH APPLICATION OR THE APPLICATION WILL NOT BE CONSIDERED.FINANCIAL ASSISTANCE OPTIONSTHE LEVEL OF FINANCIAL ASSISTANCE THAT YOU MAY BE ELIGIBLE TO RECEIVE WILL BE BASED UPON THE CRITERIA DEFINED IN THE FINANCIAL ASSISTANCE POLICY.THE WILLIAM W. BACKUS HOSPITAL CONSIDERS FINANCIAL ASSISTANCE AWARDS ON A CASE-BY-CASE BASIS. PLEASE CONTACT US IF YOU HAVE QUESTIONS REGARDING ELIGIBILITY.FINANCIALLY INDIGENTFINANCIALLY INDIGENT IS DEFINED AS AN INDIVIDUAL WHOSE TOTAL GROSS ANNUAL INCOME IS LESS THAN OR EQUAL TO 250% OF THE FEDERAL POVERTY GUIDELINES (FPG).PATIENTS AT OR BELOW 250% FPG ARE ELIGIBLE FOR A 100% DISCOUNT OFF OF THEIR OUTSTANDING BALANCES. INDIVIDUALS ABOVE 250% UP TO 400% FPG ARE ELIGIBLE FOR A DISCOUNT BASED ON THEIR TOTAL GROSS ANNUAL INCOME.MEDICALLY INDIGENTBACKUS HOSPITAL CONSIDERS AN INDIVIDUAL TO BE MEDICALLY INDIGENT IF THEIR TOTAL ANNUAL GROSS INCOME IS ABOVE 400% FPG AND THEIR OUTSTANDING MEDICAL OBLIGATIONS ARE GREATER THAN 50% OF THEIR TOTAL ANNUAL GROSS INCOME.THESE INDIVIDUALS MAY BE ELIGIBLE FOR A DISCOUNT SEPARATE FROM TRADITIONAL FINANCIAL ASSISTANCE. PLEASE REFER TO THE FINANCIAL ASSISTANCE POLICY FOR DETAILS REGARDING ELIGIBILITY AND THE DISCOUNT SCHEDULE.MEDICALLY INDIGENT IS DEFINED BY THE IRS AS: PERSONS WHOM THE ORGANIZATION HAS DETERMINED ARE UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS BECAUSE THEIR MEDICAL BILLS EXCEED A CERTAIN PERCENTAGE OF THEIR FAMILY OR HOUSEHOLD INCOME OR ASSETS (FOR EXAMPLE, DUE TO CATASTROPHIC COSTS OR CONDITIONS), EVEN THOUGH THEY HAVE INCOME OR ASSETS THAT OTHERWISE EXCEED THE GENERALLY APPLICABLE ELIGIBILITY REQUIREMENTS FOR FREE OR DISCOUNTED CARE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.BACKUS HOSPITAL TREATS EACH APPLICATION INDIVIDUALLY. IF YOU HAVE ANY QUESTIONS ABOUT YOUR SPECIFIC SITUATION, PLEASE CONTACT OUR CUSTOMER SERVICE REPRESENTATIVES AT 860-889-8331, EXT. 2917, MONDAY THROUGH FRIDAY FROM 7:30 AM TO 4 PM.FINANCIAL ASSISTANCE LETTERTHE WILLIAM W. BACKUS HOSPITAL PROVIDES FINANCIAL ASSISTANCE FOR CERTAIN QUALIFIED PATIENTS WHO ARE UNABLE TO PAY ALL OR PART OF THEIR BILL FOR INPATIENT, OUTPATIENT AND EMERGENCY SERVICES RENDERED AT THE HOSPITAL.IF YOU ARE COPING WITH A FINANCIAL HARDSHIP AND ARE FACING DEBTS OWED TO THE WILLIAM W. BACKUS HOSPITAL, FINANCIAL ASSISTANCE SUCH AS FREE CARE OR A SLIDING SCALE DISCOUNT MAY BE AVAILABLE TO YOU. THE FINANCIAL COUNSELING PROCESS WILL INDICATE WHAT OPTIONS EXIST TO ASSIST YOU WITH YOUR OUTSTANDING BALANCE.FINANCIAL ASSISTANCE APPLIES TO BACKUS HOSPITAL BILLS ONLY. IT DOES NOT APPLY TO RADIOLOGISTS, PATHOLOGISTS, ANESTHESIOLOGISTS OR OTHER PROFESSIONAL SERVICES INVOLVED IN YOUR CARE THAT ARE BILLED SEPARATELY.FREQUENTLY ASKED QUESTIONS 1. DOES THE HOSPITAL HAVE A FINANCIAL ASSISTANCE POLICY?THE WILLIAM W. BACKUS HOSPITAL DOES HAVE A WRITTEN FINANCIAL ASSISTANCE POLICY THAT DEFINES THE DISCOUNT STRUCTURE AND PROGRAMS AVAILABLE TO QUALIFYING PATIENTS.THE WILLIAM W. BACKUS HOSPITAL BASES ALL FINANCIAL ASSISTANCE ON THE MOST CURRENT FEDERAL POVERTY GUIDELINES (FPG), WHICH ARE BASED ON THE GROSS INCOME AND HOUSEHOLD SIZE.BACKUS GRANTS 100% CHARITY CARE TO THOSE APPLICANTS WHOSE GROSS HOUSEHOLD INCOME IS AT OR BELOW 250% FPG. A SLIDING DISCOUNT IS AVAILABLE TO THOSE PATIENTS WHO HAVE GROSS INCOME UP TO 400% FPG.CURRENTLY, THE FEDERAL GOVERNMENT DEFINES 100% OF POVERTY AS AN INDIVIDUAL EARNING A GROSS INCOME OF $11,670 PER YEAR. THE WILLIAM W. BACKUS HOSPITAL FINANCIAL ASSISTANCE POLICY GRANTS 100% CHARITY CARE TO A FAMILY OF ONE EARNING UP TO $29,175 PER YEAR, OR 250% FPG. INCOME THRESHOLDS INCREASE RELATIVE TO HOUSEHOLD SIZE. A DISCOUNT IS AVAILABLE FOR APPLICANTS EARNING UP TO 400% FPG.2. WHAT SERVICES DOES THE FINANCIAL ASSISTANCE POLICY COVER?THE WILLIAM W. BACKUS HOSPITALS FINANCIAL ASSISTANCE POLICY COVERS SERVICES RENDERED AT THE WILLIAM W. BACKUS HOSPITAL, INCLUDING INPATIENT, EMERGENCY, AND OUTPATIENT PROCEDURES.FINANCIAL ASSISTANCE MAY NOT BE GRANTED FOR SOME PROCEDURES, SUCH AS ELECTIVE PROCEDURES OR SOME SPECIAL SITUATIONS, SUCH AS THAT OF AN INDIVIDUAL WHO IS ELIGIBLE FOR INSURANCE BUT HAS REFUSED TO APPLY OR FUNDS ARE AVAILABLE THROUGH ANOTHER SOURCE FOR PAYMENT (I.E. SETTLEMENTS, STATE FUNDED PROGRAMS).FINANCIAL ASSISTANCE APPLIES TO BACKUS HOSPITAL BILLS ONLY. IT DOES NOT APPLY TO RADIOLOGISTS, PATHOLOGISTS, ANESTHESIOLOGISTS OR OTHER PROFESSIONAL SERVICES INVOLVED IN YOUR CARE THAT ARE BILLED SEPARATELY.3. DOES THE HOSPITAL PROVIDE PERSONNEL TO HELP WITH APPLICATIONS AND TO ANSWER QUESTIONS?THE WILLIAM W. BACKUS HOSPITAL EMPLOYS FINANCIAL COUNSELORS TO HELP PATIENTS APPLY FOR FINANCIAL ASSISTANCE, MEDICAID, AND OTHER STATE HEALTH PROGRAMS.THE HOSPITAL ALSO HAS RESOURCES TO HELP WITH APPLICATIONS FOR STATE NUTRITIONAL ASSISTANCE PROGRAMS (SNAP) AND PHARMACY ASSISTANCE PROGRAMS. FINANCIAL COUNSELORS CAN HELP TO DETERMINE APPROPRIATE REFERRALS TO THESE RESOURCES.THE WILLIAM W. BACKUS HOSPITAL PROVIDES LANGUAGE TRANSLATION VIA CYRACOM AND MARTTI LANGUAGE LINES.4. DOES THE HOSPITAL COMMUNICATE THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THE COMMUNITY?THE WILLIAM W. BACKUS HOSPITAL BELIEVES IT IS IMPORTANT TO COMMUNICATE THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THE COMMUNITIES IT SERVES. THEREFORE, A NOTICE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IS INCLUDED WITH THE PAPER BILL SENT TO THE PATIENT'S HOME, IS POSTED IN ALL MAIN REGISTRATION AREAS, IS AVAILABLE ON THE HOSPITAL'S WEBSITE, AND UPON REQUEST OF HOSPITAL STAFF OR REPRESENTATIVES.5. DOES THE HOSPITAL EVER DENY CARE BASED ON INABILITY TO PAY?THE WILLIAM W. BACKUS HOSPITAL WILL NEVER DELAY OR DENY EMERGENCY CARE OR NECESSARY SERVICES DUE TO AN INABILITY TO PAY.6. DOES THE HOSPITAL HAVE A PROGRAM FOR PATIENTS WHO DONT QUALIFY FOR TRADITIONAL FINANCIAL ASSISTANCE BUT INCUR CATASTROPHIC MEDICAL DEBTS?THE HOSPITAL HAS A WRITTEN POLICY THAT COVERS CATASTROPHIC FINANCIAL ASSISTANCE FOR THE MEDICALLY INDIGENT. THE POLICY IS INCLUDED IN THE FINANCIAL ASSISTANCE POLICY, IS AVAILABLE ON THE WEBSITE, AND UPON REQUEST.	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	PART VI LINE 3
THE WILLIAM W. BACKUS HOSPITAL IS LOCATED IN NORWICH, 45 MINUTES SOUTHEAST OF HARTFORD. IN THE PAST DECADE, THE REGION HAS UNDERGONE MAJOR ECONOMIC CHANGES, DUE TO THE OPERATION OF TWO NATIVE-AMERICAN OWNED ENTERTAINMENT VENUES BRINGING THOUSANDS OF VISITORS INTO THE REGION EACH DAY. THE CASINOS ARE THE LARGEST EMPLOYERS, AND ARE EXPERIENCING LAYOFFS AND CUTBACKS AS THE ECONOMY CONTINUES TO DECLINE. THE HOSPITAL'S PRIMARY SERVICE AREA HAS AN ESTIMATED POPULATION OF ABOUT 134,111. THE SECONDARY SERVICE AREA CONSISTS OF LARGER COMMUNITIES, SUCH AS NEW LONDON AND GROTON, AND SMALLER LOWER-DENSITY RURAL COMMUNITIES. THE TOTAL POPULATION OF THE SECONDARY SERVICE AREA IS ABOUT 136,881. THE SERVICE AREAS CONTAIN MUNICIPALITIES IN THE NEW LONDON AND WINDHAM COUNTIES.A DETAILED ANALYSIS OF THE COMMUNITIES WHICH BACKUS SERVES CAN BE FOUND WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT, IN BOTH THE SECONDARY DATA PROFILE AND THE FINAL REPORT, LINKED BELOW:SECONDARY DATA PROFILE, BEGINNING ON PAGE 4:HTTP://BACKUSHOSPITAL.ORG/WP-CONTENT/UPLOADS/2013/05/SECONDARY-DATA-PROFILE-WILLIAM-W-BACKUS-HOSPITAL-2012-CHNA-2012-10-24-REV.PDFFINAL REPORT, BEGINNING ON PAGE 3:HTTP://BACKUSHOSPITAL.ORG/WP-CONTENT/UPLOADS/2013/05/CHNA-FINAL-REPORT.PDF	COMMUNITY INFORMATION	PART VI 4
A) THE HOSPITAL IS GOVERNED BY A VOLUNTEER COMMUNITY BOARD OF DIRECTORS/TRUSTEES. THESE INDIVIDUALS REPRESENT AN ARRAY OF PROFESSIONS AND BACKGROUNDS. B) THE HOSPITAL HAS 110 CORPORATORS VOLUNTEER MEMBERS CHOSEN FROM ALL THE COMMUNITIES IN OUR PRIMARY AND SECONDARY SERVICE AREAS. IN ADDITION TO THEIR OFFICIAL CAPACITY AS NOMINATORS OF BOARD MEMBERS, THE CORPORATORS SERVE AS THE HOSPITAL'S EYES AND EARS THROUGHOUT ITS SERVICE AREA. C) THE HOSPITAL OWNS AND OPERATES A MOBILE HEALTH RESOURCE CENTER- A 40-FOOT VAN AND A SMALLER CAREVAN THAT TRAVELS TO VARIOUS LOCATIONS IN EASTERN CONNECTICUT OFFERING HEALTH EDUCATION, COUNSELING, AND SCREENINGS. THE VANS MAKE REGULARLY SCHEDULED STOPS AT SENIOR CITIZEN CENTERS, SOUP KITCHENS, ELDERLY HOUSING COMPLEXES, AND HOMELESS SHELTERS. NOT-FOR PROFIT GROUPS ARE ENCOURAGED TO REQUEST THE VANS AND THEIR SERVICES AT THEIR FUNCTIONS OR OFFICES. D) THE HOSPITAL PROVIDES INDIVIDUALS WHO DO NOT IDENTIFY AS HAVING A PRIMARY MEDICAL HOME WITH A FOLLOW UP VISIT POST DISCHARGE TO LINK THESE INDIVIDUALS WITH A PRIMARY CARE PHYSICIAN IN THE COMMUNITY. THIS IS FACILITATED THROUGH THE MY HEALTH DIRECT PROGRAM, A WEB-BASED TOOL THAT ALLOWS HOSPITAL STAFF TO ACCESS BLOCKED APPOINTMENTS FOR PHYSICIANS IN THE COMMUNITY. FROM 10/1/12 TO 9/30/13 THE HOSPITAL LINKED 1042 INDIVIDUALS WITH PRIMARY AND PREVENTIVE CARE. E) THE HOSPITAL PROVIDES FREE COMMUNITY PROSTATE SCREENINGS, DIABETES EDUCATION, BACKPACK SAFETY, HIV EDUCATION/TESTING, BLOOD PRESSURE TESTS, SKIN CANCER SCREENINGS, NUTRITION EDUCATION, AND MANY OTHER SERVICES. F) THE HOSPITAL PROVIDES A COMPREHENSIVE MEDICAL LIBRARY, WHICH IS OPEN TO ALL STAFF. THE LIBRARY HAS SUBSCRIPTIONS TO HUNDREDS OF MAJOR SCIENTIFIC AND CLINICAL JOURNALS, AS WELL AS AN ON-STAFF LIBRARIAN TO HELP WITH SPECIFIC REQUESTS. G) THE HOSPITAL PROVIDES FREE WEBSITE ACCESS TO COMPLETE AND CURRENT MEDICAL INFORMATION TO ANSWER CLINICAL QUESTIONS, THROUGH UPTODATE.COM, A PEER-REVIEWED ONLINE MEDICAL REFERENCE. UPTODATE COVERS MORE THAN 7,400 TOPICS IN 13 MEDICAL SPECIALTIES AND INCLUDES MORE THAN 76,000 PAGES OF TEXT, GRAPHICS, LINKS TO MEDICAL ABSTRACTS, MORE THAN 254,000 REFERENCES, AND A DRUG DATABASE. H) THE HOSPITAL PROVIDES FREE MEDICATION CARDS TO HELP PATIENTS KEEP TRACK OF THEIR CURRENT MEDICATIONS, AND ITS PHARMACISTS OFFER FREE REGULAR EDUCATION REVIEWS TO CHECK FOR POSSIBLE INTERACTIONS AND EXPIRED MEDICATION. I) THE HOSPITAL OFFERS FREE WIRELESS INTERNET (WI-FI) USE THROUGHOUT THE CAMPUS, AND PROVIDES FREE COMPUTER USE TO VISITORS. J) THE HOSPITAL PUBLISHES A MONTHLY HEALTH MAGAZINE. THE PUBLICATION CONTAINS INFORMATION ABOUT HEALTH ISSUES AND TRENDS, A CALENDAR OF FREE HEALTHCARE EDUCATION AND SCREENINGS, AND CONTACT INFORMATION FOR HEALTHCARE PROVIDERS. 44,000 COPIES ARE DISTRIBUTED MONTHLY.	PROMOTION OF COMMUNITY HEALTH	PART VI 5
ON AUGUST 1, 2013 (THE ACQUISITION DATE), HARTFORD HEALTH CARE (HHC) BECAME THE SOLE CORPORATE MEMBER OF BACKUS CORPORATION AND A FULL CORPORATE AFFILIATION WAS COMPLETED. ALL ASSETS AND LIABILITIES WERE REVALUED TO FAIR VALUES AS OF AUGUST 1, 2013. THE HOSPITAL IS CONSOLIDATED IN HHCS FINANCIALS FOR THE PERIOD AUGUST 1, 2013 TO SEPTEMBER 30, 2013.	AFFILIATED HEALTH CARE SYSTEM	PART VI 6
THE HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH THE CONNECTICUT OFFICE OF THE HEALTH ADVOCATE, OHCA.	STATE FILING OF COMMUNITY BENEFIT REPORT	PART VI 7
PLEASE SEE THE ANSWERS TO PART VI QUESTION 1.	FACILITY REPORTING GROUPS	PART VI 8

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
CHAMBER OF COMMERCE OF SE CT
914 HARTFORD TPKE	WATERFORD	CT	06385	060475490	501C6	12459	SPONSORSHIPSPONSORSHIP
DR MARTIN LUTHER KING SCHOLARSHIP TRUST FUND
PO BOX 1308	NEW LONDON	CT	06320	066107846	501C3	10000	SPONSORSHIP
CENTER FOR HOSPICE CARE
227 DURHAM STREET	NORWICH	CT	06360	222667260	501C3	8500	SPONSORSHIP
NORWICH HUMAN SERVICES
UNION STREET	NORWICH	CT	06360			10000	SPONSORSHIP
BROADWAY KIDS
12 PENNSYLVANIA AVE	NIANTIC	CT	06357			5500	SPONSORSHIP

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	2	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	3	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	SCHOLARSHIP	TypeOfGrant
Number Of Recipients	5	NumberOfRecipients
Amount Of Cash Grant	12500	AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: DONATIONS MADE FOR LOCAL EVENTS, SUCH AS SPONSORSHIPS ARE TYPICALLY ATTENDED BY HOSPITAL EMPLOYEES. FIVE SCHOLARSHIPS IN THE AMOUNT OF $2500 EACH ARE AWARDED TO STUDENTS WHO WILL ATTEND SCHOOL EITHER FOR NURSING OR IN THE MEDICAL FIELD. THE APPLICANTS ARE REVIEWED BY THE SCHOLARSHIP COMMITTEE OF THE AUXILIARY AND WINNERS ARE BASED ON ACADEMICS AS WELL AS COMMUNITY SERVICE.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	1	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DAVID WHITEHEAD
TRUSTEE/PRESIDENT/CEO	664686	0	0	0	389831	0	22000	0	17768	0	1094285	0	0	0
DANIEL LOHR
SENIOR VP/CFO	454036	0	0	0	259758	0	22000	0	17768	0	753562	0	0	0
PETER SHEA
SENIOR VP/MEDICAL DIRECTOR	454686	0	0	0	181425	0	14500	0	24684	0	675295	0	0	0
SERGIO CASILLAS
PHYSICIAN	495341	0	0	0	0	0	14500	0	24684	0	534525	0	0	0
ROBERT SIDMAN
PHYSICIAN	304139	0	101279	0	17000	0	14500	0	24915	0	461833	0	0	0
MARK TOUSIGNANT
PHYSICIAN	393232	0	121303	0	0	0	14500	0	24684	0	553719	0	0	0
FRED FENTON
PHYSICIAN	243823	0	78680	0	18800	0	22000	0	24915	0	388218	0	0	0
RICHARD GOULDING
PHYSICIAN	274634	0	82845	0	1500	0	14500	0	24684	0	398163	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReference	ExplanationExplanation
PART I, LINE 3
PART I, LINE 4B	DAVID WHITEHEAD, DANIEL LOHR AND PETER SHEA PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THERE WERE NO ACCRUALS OR CONTRIBUTIONS THAT WERE MADE TO THE PLAN DURING THE REPORTING PERIOD.THEY DID RECEIVE DISBURSEMENTS OF $377,527, $233,170 AMD $180,651, RESPECTIVELY.
PART I, LINE 7	BASE COMPENSATION FOR EXECUTIVES IS APPROVED BASED ON CRITERIA LISTED IN PART 1 LINE 3, HOWEVER A PORTION OF THAT IS HELD BACK AND SUBSEQUENTLY DISTRIBUTED BASED ON EVALUATION OF THE INDIVIDUALS PERFORMANCE AND ACCOMPLISHMENT OF THE GOALS SET AT THE BEGINNING OF THE YEAR BY AN INDEPENDENT COMPENSATION COMMITTEE. PHYSICIANS BONUSES ARE BASED ON MEETING PREESTABLISHED GOALS.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
STATE OF CT HEALTH & EDUCATIONAL FACILITIES
A	060806186	20774LSV3	2005-08-10	28992719	ADVANCED REFUND OF SERIES D, FINANCE FACILITY MASTER PLAN	0	0	0
STATE OF CT HEALTH & EDUCATIONAL FACILITIES
B	060806186	20774UC86	2008-07-02	30168922	CONSTRUCTION, RENOVATION AND IMPROVEMENTS TO THE FACILITY	0	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCd	Amount RetiredAmountRetired	Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Refunding EscrowRefundingEscrow	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Credit EnhancementCreditEnhancement	Capital ExpendituresCapitalExpenditures	Other Spent ProceedsOtherSpentProceeds	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A	3535000	28992719	755086	16750062	369723	583673	10514252	19923	2008	0	1	1	1
B	2850000	30168922		30100000	68922				2008	1	0	1	1

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest	Change In Use Bond Financed PropChangeInUseBondFinancedProp	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	0	0	0	0	0	0	0
B	0	0	0	0	0	0	0

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	Rebate Not Due YetRebateNotDueYet	Exception To RebateExceptionToRebate	No Rebate DueNoRebateDue	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated
(no name)
A	0	0	0	0	0	0	0	0	1
UBS AG
B	1				1	1	0	0	1	29.900000000000	0	0

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	1
B	1

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
DAVID WHITEHEAD DANIEL LOHR AND PE
OFFICERS OF BOTH WWBH AND CONNCARE INC	3394691	REIMBURSEMENTS PAID BY CONNCARE TO WWBH, PERFORMANCE OF SERVICES BY WWBH FOR CONNCARE, LEASED PROPERTY	0
DAVID WHITEHEAD AND DANIEL LOHR
OFFICERS OF BOTH WWBH AND OMNI HOME HEALTH	132000	MANAGEMENT FEES PAID BY OMNI TO WWBH	0
DAVID WHITEHEAD AND DANIEL LOHR
OFFICERS OF BOTH WWBH AND WWB INC	9308319	REIMBURSEMENTS PAID BY WWB TO WWBH	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	DAVID WHITEHEAD AND DANIEL LOHR HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. THEY SERVE AS AN OFFICER OR DIRECTOR FOR CONNCARE INC, WWB CORPORATION, AND BACKUS HOME HEALTH WHICH ARE RELATED FOR PROFIT COMPANIES.
FORM 990, PART VI, SECTION A, LINE 4	EFFECTIVE AUGUST 1, 2013, HARTFORD HEALTHCARE CORPORATION BECAME THE SOLE CORPORATE MEMBER OF BACKUS CORPORATION.
FORM 990, PART VI, SECTION A, LINE 6	BACKUS CORPORATION, A NOT-FOR-PROFIT 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF THE WILLIAM W BACKUS HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A	BACKUS CORPORATION, BEING THE SOLE MEMBER OF THE WILLIAM W BACKUS HOSPITAL, HAS THE RIGHT TO ELECT ALL THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B	IN ADDITION TO ANY OTHER RIGHTS AND POWERS WHICH THE MEMBER MAY HAVE UNDER LAW,THE MEMBER SHALL HAVE THE RIGHT AND POWER TO (A)APPROVE THE STRATEGIC PLAN AND THE CONSOLIDATION OR CLOSURE OF SIGNIFICANT LINES OF BUSINESS, PROGRAMS OR SERVICES (B)TO EFFECTUATE THE TRANSFER OF FUNDS TO ANOTHER AFFILIATED CORPORATION (C)TO EFFECTUATE THE HOSPITALS PAYMENT TO OR RECEIPT OF PAYMENT FROM THE CORPORATION (D)TO APPROVE THE ACQUISITION OR LEASE OF ANY EQUIPMENT AND ANY PROJECT OR CONSTRUCTION CONTRACT THAT ENTAILS AN EXPENDITURE BY THE HOSPITAL IN EXCESS OF, OR WITH A VALUE OVER, $400,000 IN ANY FISCAL YEAR AND THAT IS NOT ALREADY INCORPORATED IN AN APPROVED BUDGET (E) TO APPROVE ANY PROJECTS THAT WOULD REQUIRE A CERTIFICATE OF NEED (CON) OR FOR WHICH A CON DETERMINATION WILL BE SUBMITTED TO THE OFFICE OF HEALTH CARE ACCESS (F)TO APPROVE THE REORGANIZATION, MERGER, CONSOLIDATION OR DISSOLUTION OF THE HOSPITAL OR THE AFFILIATION OF THE HOSPITAL WITH ANOTHER HOSPITAL OR HEALTH DELIVERY SYSTEM, OR THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE OF THE HOSPITAL (G)TO APPROVE THE HOSPITALS ANNUAL OPERATING BUDGET (H)TO APPROVE PLANS FOR THE BORROWING OF ANY SUM IN EXCESS OF $400,000 WHICH HAS A STATED TERM GREATER THAN ONE YEAR OR WHICH IS SECURED BY A MORTGAGE OF ALL OR ANY PORTION OF THE HOSPITALS REAL PROPERTY OR BY A SECURITY INTEREST IN THE HOSPITALS ASSTS OR REVENUES (I)TO APPROVE AMENDMENTS TO THE CERTIFICATE OF INCORPORATION OR BYLAWS
FORM 990, PART VI, SECTION B, LINE 11	THE 990 IS PREPARED BY THE ACCOUNTING STAFF AND THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN REVIEWED BY THE CFO AND ANY QUESTIONS ADDRESSED. THE FINAL 990 IS THEN PROVIDED TO THE BOARD.
FORM 990, PART VI, SECTION B, LINE 12C	ALL TRUSTEES, OFFICERS AND KEY EMPLOYEES OF THE HOSPITAL SHALL COMPLETE AND SIGN A DISCLOSURE STATEMENT. THE STATEMENT WILL INCLUDE AN ITEMIZATION AND DESCRIPTION OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS RELATED THERETO FOR SUCH INDIVIDUAL BY VIRTUE OF HIS OR HER ACTIVITIES OR THE ACTIVITIES OF RELATED PERSONS. DISCLOSURE STATEMENTS SHALL BE RETURNED TO THE CORPORATE COMPLIANCE OFFICER WHO, UNDER THE DIRECTION OF THE CHAIR AND THE PRESIDENT, SHALL EXERCISE GOOD FAITH AND JUDGEMENT AS TO WHETHER A CONFLICT EXISTS. THE CHAIR AND THE PRESIDENT SHALL BE RESPONSIBLE FOR MONITORING TRANSACTIONS OR ARRANGEMENTS IN WHICH A TRUSTEE, OFFICER OR KEY EMPLOYEE MAY HAVE A CONFLICT OF INTEREST AND FOR ASSURING THAT INDIVIDUAL SERVES THE HOSPITAL'S BEST INTEREST. THE COMPLAINCE OFFICER, THE CHAIR AND/OR PRESIDENT MAY CONSULT WITH ANY TRUSTEE, OFFICER, OR KEY EMPLOYEE TO OBTAIN INFORMATION NECESSARY FOR AN ORDINARILY PRUDENT PERSON TO MAKE A JUDGEMENT AS TO WHETHER A CONFLICT EXISTS AND REQUESTS SHALL BE COMPLIED WITH. IF AN ACTUAL OR POTENTIAL CONFLICT ARISES, THE COMPLIANCE OFFICER SHALL BE PROMPTLY NOTIFIED IN WRITING. TRUSTEES, OFFICERS, AND KEY EMPLOYEES WHO HAVE DECLARED OR HAVE BEEN DEEMED TO HAVE A CONFLICT OF INTEREST MUST REFRAIN FROM CONSIDERATION OF PROPOSED TRANSACTIONS OR ARRANGEMENTS, UNLESS FOR SPECIAL REASON THE BOARD OF TRUSTEES REQUESTS INFORMATION OR INTERPRETATIONS.
FORM 990, PART VI, SECTION B, LINE 15	A PERFORMANCE REVIEW COMMITTEE CONSISTING OF INDEPENDENT BOARD MEMBERS REVIEWS THE PERFORMANCE OF THE SENIOR MANAGMENT TEAM. COMPENSATION IS BASED ON THE RESULTS OF THESE REVIEWS. THE COMMITTEE ALSO TAKES INTO CONSIDERATION INFORMATION FROM COMPENSATION SURVEYS.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. PLEASE CONTACT DANIEL LOHR AT 326 WASHINGTON STREET, NORWICH, CT 06360 ABOUT INSPECTING THE ORGANIZATION'S DOCUMENTS.
FORM 990, PART XI, LINE 9:	K-1 PASSTHROUGH 1,402. TRANSFER TO AFFILIATES -2,794,559. INCREASE IN ASSETS HELD IN TRUST 156,434. CHANGE IN PENSION FUNDING 41,885,288. FAIR VALUE ADJUSTMENT 51,783,116.	CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (28 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
BACKUS HEALTH CARE INC
326 WASHINGTON STREET	NORWICH	CT	06360	222481794	SUPPORT	CT	501C3	11A	BACKUS CORP	1
BACKUS CORPORATION
326 WASHINGTON STREET	NORWICH	CT	06360	222757608	SUPPORT	CT	501C3	11B		0	N/A
HARTFORD HOSPITAL
80 SEYMOUR STREET	HARTFORD	CT	06102	060646668	HEALTHCARE SERVICES	CT	501C3	3	HARTFORD HEALTHCARE CORPORATION	1
WINDHAM COMMUNITY MEMORIAL HOSPITAL
112 MANSFIELD AVE	WILLIMANTIC	CT	06226	060646966	HEALTHCARE SERVICES	CT	501C3	3	HARTFORD HEALTHCARE CORPORATION	1
MIDSTATE MEDICAL CENTER
435 LEWIS AVENUE	MERIDAN	CT	06451	060646715	HEALTHCARE SERVICES	CT	501C3	3	HARTFORD HEALTHCARE CORPORATION	1
WINDHAM HOSPITAL FOUNDATION INC
112 MANSFIELD AVE	WILLIMANTIC	CT	06226	562546632	SUPPORTING ORGANIZATION	CT	501C3	11A	WINDHAM COMMUNITY MEMORIAL HOSPITAL	1
HARTFORD HOSPITAL AUXILIARY CO HARTFORD HOSPITAL
80 SEYMOUR STREET	HARTFORD	CT	06115	066040747	FUNDRAISING	CT	501C3	11C	HARTFORD HOSPITAL	1
CONNECTICUT HEALTH SYSTEM INC
80 SEYMOUR STREET	HARTFORD	CT	06102	222779421	COORDINATION OF HEALTH DELIVERY	CT	501C3	11C		1
HARTFORD HEALTHCARE CORPORATION
80 SEYMOUR STREET	HARTFORD	CT	06102	222672834	SUPPORT & MANAGEMENT SVCS TO HHC & AFFILIATES	CT	501C3	11C		1
INSTITUTE OF LIVING
200 RETREAT AVENUE	HARTFORD	CT	06106	060646683	PSYCHIATRIC SERVICES	CT	501C3	11C	HARTFORD HEALTHCARE CORPORATION	1
NATCHAUG HOSPITAL INC
189 STORRS ROAD	MANSFIELD CENTER	CT	06226	060966963	BEHAVIORAL HEALTH	CT	501C3	3	HARTFORD HEALTHCARE CORPORATION	1
VNA HEALTHCARE INC
103 WOODLAND STREET	HARTFORD	CT	06105	060646938	HOME HEALTHCARE	CT	501C3	7	HARTFORD HEALTHCARE CORPORATION	1
VNA HEALTH RESOURCES INC
103 WOODLAND STREET	HARTFORD	CT	06105	061161422	HOME HEALTHCARE	CT	501C3	9	HARTFORD HEALTHCARE CORPORATION	1
RUSHFORD CENTER INC
883 PADDOCK AVENUE	MERIDAN	CT	06450	060932875	SUBSTANCE ABUSE HEALTHCARE SERVICES	CT	501C3	7	HARTFORD HEALTHCARE CORPORATION	1
THE HATCH HOSPITAL CORP
112 MANSFIELD AVE	WILLIMANTIC	CT	06226	066076412	HEALTHCARE SERVICES	CT	501C3	3	WINDHAM COMMUNITY MEMORIAL HOSPITAL	1
WCMH WOMEN'S AUXILIARY INC
112 MANSFIELD AVE	WILLIMANTIC	CT	06226	060677728	FUNDRAISING	CT	501C3	11A	WINDHAM COMMUNITY MEMORIAL HOSPITAL	1
THE HOSPITAL OF CENTRAL CT & BRADLEY MEMORIAL
110 GRAND STREET	NEW BRITAIN	CT	06050	060646768	HEALTHCARE SERVICES	CT	501C3	3	HARTFORD HEALTHCARE CORPORATION	1
CENTRAL CT SENIOR HEALTH DBA SOUTHING CARE CENTER
45 MERIDEN AVENUE	SOUTHINGTON	CT	06489	222635676	SUB-ACUTE & LONG TERM CARE	CT	501C3	9	HARTFORD HEALTHCARE CORPORATION	1
BRADLEY HEALTH SERVICES
100 GRAND STREET	NEW BRITAIN	CT	06050	061367014	HEALTHCARE SERVICES	CT	501C3	9	HARTFORD HEALTHCARE CORPORATION	1
CENTRAL CT HEALTH ALLIANCE
100 GRAND STREET	NEW BRITAIN	CT	06050	222785033	SUPPORT & MANAGEMENT SVCS TO THOCC & AFFILIATES SHELL	CT	501C3	11B	HARTFORD HEALTHCARE CORPORATION	1
VNA OF CENTRAL CT INC
205 WEST MAIN STREET	NEW BRITAIN	CT	06050	060646940	PUBLIC HEALTH NURSING & HOME CARE	CT	501C3	9	HARTFORD HEALTHCARE CORPORATION	1
THE ORCHARDS OF SOUTHINGTON
34 HOBART STREET	SOUTHINGTON	CT	06489	061490803	RESIDENTIAL SERVICES FOR SENIOR CITIZENS	CT	501C3	9	CENTRAL CT SENIOR HEALTH SERVICES INC	1
COMMUNITY MENTAL HEALTH AFFILIATES
270 JOHN DOWNEY DRIVE	NEW BRITAIN	CT	06051	060934544	MENTAL HEALTH & SUBSTANCE ABUSE TREATMENT PROVIDER	CT	501C3	7	HARTFORD HEALTHCARE CORPORATION	1
MULBERRY GARDENS OF SOUTHINGTON LLC
58 MULBERRY STREET	PLANTSVILLE	CT	06479	820586577	ASSISTED LIVING & ADULT DAY CARE	CT	501C3	9	CENTRAL CT SENIOR HEALTH SERVICES INC	1
MIDSTATE MEDICAL CENTER AUXILIARY
435 LEWIS AVENUE	MERIDAN	CT	06451	066063082	FUNDRAISING	CT	501C3	3	MIDSTATE MEDICAL CENTER	1
HHC PHYSICIANS CARE INC
80 SEYMOUR STREET	HARTFORD	CT	06102	454456939	PRACTICE MEDICINE & PROVIDE HEALTH CARE TO THE PUBLIC	CT	501C3	9	HARTFORD HEALTHCARE CORPORATION	1
HARTFORD HEALTHCARE ACCOUNTABLE CARE ORG INC
200 RETREAT AVENUE	HARTFORD	CT	06102	460886367	MANAGE & COORDINATE CARE FOR MEDICARE BENEFICIARIES	CT	501C3	11C	HARTFORD HEALTHCARE CORPORATION	1
HARTFORD HEALTHCARE CORP GROUP EMPLOYEE BENEFIT PLAN TRUST
C/O BOA 777 MAIN STREET	HARTFORD	CT	06102	266671355	PROVIDE BENEFITS TO EMPLOYEES	CT	501C9		HARTFORD HEALTHCARE CORPORATION	1

Form990 Schedule R Part III Form990ScheduleRPartIII (11 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets
OMNI HOME HEALTH
12 CASE STREET	NORWICH	CT	06360	061458837	HOME HEALTH CARE	CT	WWB INC	RELATED	0	0
CENTRAL CT SPORT MEDICINE CTR LLC
15 MASAIRIO DRIVE STE 104	BERLIN	CT	06037	223196509	PHYSICAL THERAPY	CT	CCHA	RELATED	0	0	0.50000
NEW BRITAIN MRI LIMITED PARTNERSHIP
100 GRAND STREET	NEW BRITAIN	CT	06050	061271349	MAGNETIC RESONANCE IMAGING	CT	CENCONN SERVICES INC	RELATED	0	0	0.56600
NEW BRITAIN OCCUPATIONAL HEALTH CENTER LLC
440 NEW BRITAIN AVENUE	PLAINVILLE	CT	06062	061484904	OCCUPATIONAL HEALTHCARE	CT	HCC	RELATED	0	0	0.85700
HARTFORD HEALTHCARE ENDOWMENT LLC
80 SEYMOUR STREET	HARTFORD	CT	06102	454181103	ENDOWMENT MANAGEMENT	CT		RELATED	0	0	1.00000
AMBULANCE SERVICE OF MANCHESTER
PO BOX 300	MANCHESTER	CT	06450	061557358	AMBULATORY SERVICE	CT		RELATED	0	0	0.50000	1515570	3805580
CT IMAGING PARTNERS LLC
111 FOUNDERS PLACE	EAST HARTFORD	CT	06108	134298940	IMAGING SERVICES	CT		UNRELATED	0	0	0.50000	294336	1096009
GLASTONBURY ENDOSCOPY CENTER LLC
300 WESTERN BLVD STE B	GLASTONBURY	CT	06033	261721234	ENDOSCOPY SERVICES	CT		RELATED	0	0	0.50000	446859	123624
GLASTONBURY SURGERY CENTER LLC
195 EASTERN BLVD	GLASTONBURY	CT	06033	262600828	SURGERY SERVICES	CT		RELATED	0	0	0.50000	1463349	-100242
HARTFORD-MIDDLESEX CLINICAL SYSTEM LLC
80 SEYMOUR STREET	HARTFORD	CT	06110	061543605	AFFILIATE SUPPORT SERVICE	CT		UNRELATED	0	0	0.50000	-135
MED EAST ASSOC LLC
1703 WEST MAIN STREET	WILLIMANTIC	CT	06226	061469575	OUTPATIENT CARE CLINIC	CT		RELATED	0	0	0.50000	33012	234623

Form990 Schedule R Part IV Form990ScheduleRPartIV (14 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Controlled OrgControlledOrg	Percentage OwnershipPercentageOwnership	Address Line1AddressForeign/AddressLine1	CityAddressForeign/City	CountryAddressForeign/Country	Legal Domicile Foreign CountryLegalDomicileForeignCountry
WWB CORPORATION
326 WASHINGTON STREET	NORWICH	CT	06360	061094836	HOLDING COMPANY	CT	BACKUS CORPORATION	C	1
CONNCARE INC
326 WASHINGTON STREET	NORWICH	CT	06360	061387598	HEALTHCARE SERVICES	CT	BACKUS HEALTH CARE INC	C	1
BACKUS MEDICAL CENTER CONDO ASSOC INC
330 WASHINGTON STREET	NORWICH	CT	06360	061542647	CONDO ASSOCIATION	CT	THE WILLIAM W BACKUS HOSPITAL	C	1	0.65000
HHMOB CORPORATION& SUBSIDIARY
80 SEYMOUR STREET	HARTFORD	CT	06102	061140244	REAL ESTATE PARKING	CT		C	1	1.00000
CHS INSURANCE LTD
					CAPTIVE INSURANCE			C	1	0.72500	FB PERRY BLVD 40 CHURCH ST	HAMILTON	BD	BD
WINDHAM HEALTH SERVICES INC
112 MANSFIELD AVENUE	WILLIMANTIC	CT	06226	061461101	HOME HEALTHCARE	CT	WINDHAM	C	1	1.00000
WINDHAM PHYSICIAN HOSPITAL ORGANIZATION
112 MANSFIELD AVENUE	WILLIMANTIC	CT	06226	061441614	MEDICAL SERVICES	CT		C	1	0.50000
WINDHAM FAMILY MEDICAL SERVICES
112 MANSFIELD AVENUE	WILLIMANTIC	CT	06226	061491649	MEDICAL SERVICES	CT	WINDHAM	C	1
CENCONN SERVICES INC
100 GRAND STREET	NEW BRITAIN	CT	06050	222836001	INVESTMENT MANAGAMENT	CT	CCHA	C	1
GRAND INDEMNITY CO LTD
				980609499	PROFESSIONAL LIABILITY		THOCC	C	1	1.00000	40 CHURCH STREET	HAMILTON	BD	BD
HARTFORD PHYSICIAN SERVICES
80 SEYMOUR STREET	HARTFORD	CT	06102	061254082	MEDICAL SERVICES	CT	HARTFORD HOSPITAL	C	1
MERIDEN IMAGING CENTER
101 NORTH PLAINS INDUSTRIAL RD	MERIDEN	CT	06429	061541468	IMAGING	CT	MIDSTATE	S	1	0.80000
HARTFORD HEATHCARE CORP DEFINED BENEFIT MASTER TRUST
80 SEYMOUR STREET	HARTFORD	CT	06102	454530568		CT	HARTFORD HEALTHCARE CORP	T	1
HARTFORD PHYSICIAN HOSPITAL ORGANIZATION INC
80 SEYMOUR STREET	HARTFORD	CT	06102	222785918	PHYSICIAN & HOSPITAL SUPPORT	CT	HARTFORD HEALTHCARE CORP	C	1	0.50000

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
CONNCARE INC
J	469866	COST
OMNI HOME HEALTH
L	132000	COST
CONNCARE INC
L	97253	COST
CONNCARE INC
Q	2827572	COST
WWB INC
Q	9308319	COST